N6521 N: Mary is a 35-year-old woman that has been diagnosed with hypothyroidism. Her labs today show a TSH of 20, MCV 78, MCHD 26, Ferritin 9, TIBC 418. She has a history of iron deficiency anemia for 2 months. Current medications include Kelp tablets daily, ibuprofen 400 mg daily as needed, and ethinyl estradiol/norgestrel […]

A 26-year-old woman presents with suicidal ideation. She exhibits a depressed mood and has had a lack of pleasure in activities, insomnia, guilt, weight loss, and poor concentration. She has attempted suicide in the past and continues to consider self-harm. Three months ago, she had an episode of increased energy, grandiosity, promiscuity, flight of ideas, […]

A 22-year-old woman presents in clinic to follow up on a recent diagnosis of generalized anxiety disorder. She started taking sertraline 25 mg per day for a week and then titrated up to 50 mg per day for the next five weeks. She hasn’t noticed any symptom improvement. Which of the following is the best […]

A 22-year-old man with a history of schizophrenia has been admitted to the psychiatric department. He had been in remission for 2 years but has been having auditory hallucinations of hearing voices for the past 6 months. He does not seem to understand the questions that he is being asked and appears anxious. He has […]

A 35-year old female presents to the clinic with fever, dysuria, and frequent urination; she is prescribed antibiotics. Two weeks later, the patient presents to the ER with complaints of worsening symptoms. Patient states that they never picked up the originally prescribed antibiotic. Patient has a fever and elevated WBC count. Urinalysis is positive for […]

A 25-year-old woman presents to the emergency department with complaints of abdominal pain, vomiting, and diarrhea that has been present for five years. She states that no one has been able to help her up to this point. She reports numerous allergies to a variety of medications. Physical exam reveals moist mucous membranes, multiple well-healed […]

A 35-year-old woman presents to her primary care office with a 3-month history of dull headaches, insomnia, and irritability. She has difficulty concentrating and says she is disinterested in her favorite activities. She states she has been having nightmares and frequent flashbacks of her time overseas. The patient recently left the military and is currently […]

The client is 76 years old and has recently experienced a fall in their home. The client was carrying a box of children’s books to the den and slipped on a rug. The client fell and called for help. The client’s daughter was in the other room and called 911. The client has osteoporosis which […]

The 35 year old patient with a diagnosis of a right CVA is currently participating in skilled occupational, physical, and speech- language therapies at a local inpatient rehabilitation hospital. The patient has trace movement in her left lower and upper extremities (0 MMT). The patient is able to sit at the EOB with supervision but […]

The client is 45 years old and has decided to get elective unilateral knee arthroplasty to their left knee after experiencing pain for several years. The client receives occupational and physical therapy in acute care to work on functional mobility goals before being discharged home. The surgeon is requiring the client to wear a knee […]